规定减少剂量直接口服抗凝药的偏好,用于延长期静脉血栓塞栓症治疗
Danielle Groat1, Karlyn A Martin2, Rachel P Rosovsky3
1Center for Humanizing Critical Care, Intermountain Medical Center, Murray, UT, United States of America.
Thrombosis research
|May 9, 2025
概括
大多数临床医生减少剂量直接口服抗凝剂 (DOACs) 延长VTE预防. 处方模式因提供者类型和患者数量而异,突出显示了针对最佳抗凝管理的教育需求.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 心血管医学 心血管医学
- 临床药房 临床药房
背景情况:
- 直接口服抗凝剂 (DOAC),如阿皮克萨班和里瓦罗克萨班,用于静脉血栓塞栓症 (VTE).
- 产品标签建议在延长期VTE二次预防中减少剂量.
- 了解目前对DOAC的处方模式对于优化患者护理至关重要.
研究的目的:
- 研究不同类型的临床医生之间直接口服抗凝剂 (DOAC) 的处方模式.
- 在延长期VTE预防中,确定影响DOAC剂量减少决策的因素.
主要方法:
- 对对血栓形成专家和初级保健医生 (PCP) 进行的一项调查的二次分析.
- 使用了描述性统计,费舍尔的精确测试和回归分析.
- 检查了临床医生人口统计和DOAC处方行为之间的关系.
主要成果:
- 在336名受访者中,88%的药剂师,78%的专家和61%的PCP报告了延长VTE治疗的剂量降低DOAC.
- 在高风险情景中,初级保健医生最有可能暂时升级剂量.
- 管理超过250名DOAC患者的临床医生更有可能减少剂量 (aOR 2.41).
- 药剂师主要喜欢阿皮克萨班,而PCP和专家显示阿皮克萨班和里瓦罗克萨班的处方均衡.
结论:
- 大多数临床医生在抗凝血治疗的延长阶段实施DOAC剂量减少.
- 处方实践受到提供者专业和患者病情的重大影响.
- 这些发现强调了需要针对临床医生就适当的DOAC剂量减少策略进行有针对性的教育.
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